NUR 100 Week 6

Sherpath Lesson – Spread of Infection

KEY POINTS
6 Components of Chain of Infection

A. Infectious agent
1 B.
C.
Source of infection
Portal of exit
D. Mode of transmission
E. Portal of entry
F. Susceptible host

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 NUR 100 Week 6
Sherpath Lesson – Spread of Infection

1) The infectious process begins with the chain of infection.

2) PATHOGEN - any infectious agent that causes disease is referred to as a i.e.

a) Bacteria
b) Viruses
c) Fungi
d) parasites.

3) RESERVIOR - the source of infection (is where the infectious agent lives, receives nourishment, and multiples. i.e.

a) Human
b) Animal
c) nonhuman (soil, food, water).

4) PORTAL OF EXIT is the means by which the infectious agent leaves the reservoir of infection.

5) MODE OF TRANSMISSION is the method by which the infectious agent travels from the reservoir to
the susceptible host. Modes of transmission include contact, vehicle, and vector-borne.

6) PORTAL OF ENTRY is the means by which the infectious agent enters the susceptible host. This portal is essential for
the chain of infection to continue and the microorganism to be successfully transmitted from a primary host to a
susceptible host.

7) SUSCEPTIBLE HOST is a person with risk factors for infection, who will likely contract the disease after the infectious
agent gains entry through a portal of entry.

8) Any time the chain of infection can be broken, it enhances the potential for preventing patients from developing
infections.

9) Health care–associated infections (HAIs) are infections acquired by patients while receiving care in a health care
facility such as a hospital, long-term care facility, medical clinic, or primary care office.

10) HAIs are associated with the use of medical devices, ineffective cleaning of equipment, lax or lack of handwashing,
patient or health care worker transmission of infectious material, and patient vulnerability.

11) Blood-borne pathogens are important because the most common way health care workers are exposed to them is
through needlesticks and other sharps-related injuries.

12) Microorganisms adapt to their environment to compete for survival. When the microorganisms develop resistance
to medications that had been previously successful at treating the infection, this is called drug resistance.

13) Many factors contribute to resistance, including overprescribing of antibiotics for nonbacterial infections, use of
inappropriate antibiotics for the infecting microorganism, and incomplete courses of antibiotics.

14) Resistance is seen in both community- and hospital-acquired infections.

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NUR 100 Week 6
Sherpath Lesson – Spread of Infection

Pathogen - Any infectious agent that causes disease

2 Pathogenicity/Virulence - Varying degrees of pathogen’s ability to cause disease
A. Bacteria
 Single-cell organisms
 May be opportunistic, causing disease when the immune system is compromised
 Different sizes, shapes, growth patterns
 Reproduce by dividing one cell into two identical cells
 Identified by culturing a sample taken from the body
 Undergo testing to determine sensitivity to exact antibiotics to ensure effective antibiotics are prescribed
 May live as normal flora on and in the skin, eyes, nose, mouth, upper throat, lower urethra, lower intestine,
and large intestine
B. Viruses
 Microscopic infectious agents
 Reproduce inside living cells of the host
 Responsible for causing many different types of disease
 Responsible for illnesses ranging from the common cold to HIV/AIDS
 Protective envelope cannot be destroyed by antibiotics
 Managed with certain antiviral medications used to control symptoms and decrease the length of illness if
given during the early phases of illness
C. Fungi
 Single-cell organisms
 Include molds and yeast
 Found in air, soil, and water
 Responsible for conditions such as athlete’s foot, ringworm, and yeast infections
 Treated with antifungal medications
D. Parasites
 Organisms that benefit from or live on other organisms
 Protozoa, helminths, and arthropods are primarily pathogenic to humans:
o Protozoa cause malaria
o Helminths cause intestinal worms
o Arthropods cause skin and systemic diseases
 Transmitted by sexual contact, insects, and domestic animals
 Parasites are treated with anthelminthic, antimalarial, and antiparasitic agents
3  Where pathogen lives, receives nourishment and multiplies
3 Reserviors  2nd link of infection ( source of infection )

A. Human
 People transmit pathogens when:
o They have active infectious diseases
o They are infected, but are asymptomatic carriers
 Patients, health care personnel, family, or friends can serve as reservoirs for infectious agents
B. Animal  Insects  Animals such as mice, rats, pigs, cows
 Birds
C. Inanimate
 Soil contaminated with pathogens such as fungi, mold, helminths, and bacteria
 Water contaminated with feces and urine

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NUR 100 Week 6
Sherpath Lesson – Spread of Infection

 Food contamination can result from improper handling and storage of food
 Contaminated hospital equipment, surfaces, etc.
5 Portals of  Pathways for pathogens to leave reservoir to they can travel to next host
4 EXIT

 Respiratory tract: Sputum, Cough, Sneezing  Open lesions on the skin: Blood, Wound drainage
 Gastrointestinal tract: Emesis, Stool  Urinary tract: Urine
 Genitourinary tract: Genital secretions
3 Modes  Pathogen’s way to travel from the source to next host
5 of Transmission  Transmission-based precautions are required for these patients.
A. Contact transmission
a. Direct contact
 is the physical transfer of microorganism (pathogens) from between hosts i.e.
o between the infected individual directly to a susceptible host through:
 Kissing  Sexual contact
 touching  Oral-fecal route
b. Indirect contact
 transfer of microorganisms between hosts by means of an inanimate object, called a FOMITE. i.e.
 Dressing  toys  dishes
 medical equipment or supplies  diapers  contaminated needles
 clothing  money  air.
 Airborne transmission occurs when AIR serves as the transmission vehicle.
o Microorganisms are dispersed by air currents that travel greater than one meter and are inhaled
or deposited on the skin of a susceptible host.
o TB, measles, and chickenpox can be transmitted through air conditioning and cooling systems,
forceful coughing, and pathogens attached to dust particles, sweeping, and by changing bed
linens.
 Droplets are infectious agents transferred by SMALL RESPIRATORY BEADS (DROPLETS) from
infected host to susceptible host through coughing, sneezing, laughing, or simply by exhaling.
o Influenza and respiratory syncytial virus (RSV) are transmitted via droplets (CDC, 2018).
B. Vehicle Transmission
 Waterborne/foodborne transmission - water or food serve as the transmission vehicle.
 Pathogens are transmitted to the susceptible host when water is contaminated by untreated sewage or food
is contaminated with feces.
 Pathogens that are transmitted by contaminated food and/or water i.e.
 Salmonella  hepatitis A  Escherichia coli

Depending on the pathogen, standard precautions, or standard plus other specific transmission precautions
may be required for these patients.
C. Vector-borne Transmission – vectors CARRY pathogens from one host to another
 Biological vectors PARTICIPATE in the pathogen’s life cycle and transmit disease.
o can be animals or insects. i.e.
 Mosquitoes carry West Nile, malaria, yellow fever, and viral encephalitis
 ticks carry Lyme disease  Lice carry epidemic typhus
o Each of these passes the pathogens along to susceptible hosts when they bite the host.
 Mechanical vectors PASSIVELy pass the pathogen from host to the next susceptible host.

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NUR 100 Week 6
Sherpath Lesson – Spread of Infection

o DO NOT PARTICIPATE in the pathogen’s life cycle, but are capable of passing the pathogen passively
along. i.e.
 common housefly contaminating food causing dysentery and intestinal worms
 cockroaches causing the foodborne disease giardiasis through food contamination.
